Workforce planning is always critical, but the need to find the ‘right people for the right place at the right time’ has rarely been more challenging than currently in Australia’s healthcare sector.
In an ageing population beset with risk factors, including obesity and a shift to physical inactivity, the sector faces the prospect of buckling under the weight of community expectations in five, 10 or 20 years.
Meanwhile, its costs continue to soar while ever-changing governments eke out additional funding and bicker about who’s responsible for finding more.
Then there are the structural issues in what is a fragmented and largely uncoordinated sector complicated by social inequities between regional and urban communities, Indigenous and non-Indigenous Australians, and those who can afford private healthcare and those who can’t.
The prevailing overview is that healthcare has failed in major respects to move on from its roots when services popped up here and there.
“The biggest challenge at the moment is that healthcare is a series of cottage industries in this country and there is no serious attempt to try to integrate care,” said former Australian of the Year Professor Ian Frazer in the Future Solutions in Australian Healthcare whitepaper, released in August.
A case in point is the rise and demise of Health Workforce Australia (HWA), the national agency tasked with addressing, in its own words, the “complex health workforce issues”. It was launched with great fanfare in 2010 after the Council of Australian Governments recognised that “reform must be national and large-scale, and it must cut across jurisdictional, sectoral and professional boundaries”.
Then, after the Abbott government came to power, it was shut down a few months ago, with workforce planning being folded back into its old home at the Department of Health.
It is a move that Australian Healthcare and Hospitals Association CEO, Alison Verhoeven, is watching closely.
“The work that was done was important work,” she says. “It was used to model health workforce needs into the future, and also to look at health workforce shortages. We know there are shortages, not just in rural and remote areas, but in particular occupations and in other parts of the country as well.
“Making sure we have an overall spread of the right professionals across the country is very important, and it’s only possible if national strategies are in place.”
Verhoeven says the shift from HWA back to the department has put health workforce planning in “a little bit of a hiatus”, but she’s hopeful it will spark up again when the transfer is complete.
The need for a national vision isn’t the only piece of the puzzle. “Numerous things get in the road of a well-managed health workforce,” she says, listing professional privilege, government funding methodologies and “appropriate competency standards and training for lower-level professional groups seeking work that might have been done by more skilled groups in the past”.
Behind the scenes, many aged care providers are lobbying government to have funding less tied to political cycles to support longer-term planning.
Ad hoc budget cuts are adding to the challenges. Decisions made in the health sector today can have ramifications later on – for example, increased chronic disease rates due to a lack of prevention measures.
As demand for services grows, there’s little question that looking after the health of Australians will continue to become more expensive, per capita, for many years to come. Treasury projects that the annual growth rate of health care expenditure versus gross domestic product will almost double from 4 to 7 per cent by 2050. Already, healthcare costs the nation $140 billion a year, which is equivalent to about 9.1 per cent of GDP (around the average of other OECD countries).
Despite these challenges, the outcomes of Australia’s health sector are relatively good – the average life expectancy and overall wellbeing of Australians rank as being the sixth highest in the world.
Of course, healthcare relies heavily on human capital, notes Verhoeven. So it makes sense that, if workforce planning is working well, it will flow through to the health of the nation as a whole.
This article is an edited version. The full article was first published in the February 2015 issue of HRMonthly magazine as ‘Who will care for us?’ AHRI members receive HRMonthly 11 times per year as part of their membership. Find out more about AHRI membership here.